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4.
PLoS One ; 15(2): e0228542, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32040510

RESUMO

OBJECTIVE: The need to align investments in health research and development (R&D) with public health needs is one of the most important public health challenges in Japan. We examined the alignment of disease-specific publicly competitive R&D funding to the disease burden in the country. METHODS: We analyzed publicly available data on competitive public funding for health in 2015 and 2016 and compared it to disability-adjusted life year (DALYs) in 2016, which were obtained from the Global Burden of Disease (GBD) 2017 study. Their alignment was assessed as a percentage distribution among 22 GBD disease groups. Funding was allocated to the 22 disease groups based on natural language processing, using textual information such as project title and abstract for each research project, while considering for the frequency of information. RESULTS: Total publicly competitive funding in health R&D in 2015 and 2016 reached 344.1 billion JPY (about 3.0 billion USD) for 32,204 awarded projects. About 49.5% of the funding was classifiable for disease-specific projects. Five GDB disease groups were significantly and relatively well-funded compared to their contributions to Japan's DALY, including neglected tropical diseases and malaria (funding vs DALY = 1.7% vs 0.0%, p<0.01) and neoplasms (28.5% vs 19.2%, p<0.001). In contrast, four GDB disease groups were significantly under-funded, including cardiovascular diseases (8.0% vs 14.8%, p<0.001) and musculoskeletal disorders (1.0% vs 11.9%, p<0.001). These percentages do not include unclassifiable funding. CONCLUSIONS: While caution is necessary as this study was not able to consider public in-house funding and the methodological uncertainties could not be ruled out, the analysis may provide a snapshot of the limited alignment between publicly competitive disease-specific funding and the disease burden in the country. The results call for greater management over the allocation of scarce resources on health R&D. DALYs will serve as a crucial, but not the only, consideration in aligning Japan's research priorities with the public health needs. In addition, the algorithms for natural language processing used in this study require continued efforts to improve accuracy.


Assuntos
Pesquisa Biomédica/economia , Doença/economia , Competição Econômica , Apoio Financeiro , Carga Global da Doença , Custos de Cuidados de Saúde/estatística & dados numéricos , Pesquisa Biomédica/estatística & dados numéricos , Doença/classificação , Financiamento Governamental/classificação , Financiamento Governamental/organização & administração , Financiamento Governamental/normas , Carga Global da Doença/economia , Carga Global da Doença/organização & administração , Carga Global da Doença/normas , Carga Global da Doença/estatística & dados numéricos , Humanos , Classificação Internacional de Doenças , Investimentos em Saúde/economia , Investimentos em Saúde/estatística & dados numéricos , Japão/epidemiologia , Saúde Pública/economia , Anos de Vida Ajustados por Qualidade de Vida , Pesquisa/economia , Pesquisa/estatística & dados numéricos
5.
Aust N Z J Public Health ; 44(2): 145-151, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32050304

RESUMO

OBJECTIVE: To examine: alcohol and fast food sponsorship of junior community sporting clubs; the association between sponsorship and club characteristics; and parent and club representative attitudes toward sponsorship. METHODS: A cross-sectional telephone survey of representatives from junior community football clubs across New South Wales and Victoria, Australia, and parents/carers of junior club members. Participants were from junior teams with Level 3 accreditation in the 'Good Sports' program. RESULTS: A total of 79 club representatives and 297 parents completed the survey. Half of participating clubs (49%) were sponsored by the alcohol industry and one-quarter (27%) were sponsored by the fast food industry. In multivariate analyses, the odds of alcohol sponsorship among rugby league clubs was 7.4 (95%CI: 1.8-31.0, p=<0.006) that of AFL clubs, and clubs located in regional areas were more likely than those in major cities to receive fast food industry sponsorship (OR= 9.1; 95%CI: 1.0-84.0, p=0.05). The majority (78-81%) of club representatives and parents were supportive of restrictions to prohibit certain alcohol sponsorship practices, but a minority (42%) were supportive of restrictions to prohibit certain fast food sponsorship practices. CONCLUSIONS: Large proportions of community sports clubs with junior members are sponsored by the alcohol industry and the fast food industry. There is greater acceptability for prohibiting sponsorship from the alcohol industry than the fast food industry. Implications for public health: Health promotion efforts should focus on reducing alcohol industry and fast food industry sponsorship of junior sports clubs.


Assuntos
Bebidas Alcoólicas , Fast Foods , Indústria Alimentícia/economia , Futebol Americano/economia , Marketing/métodos , Marketing/organização & administração , Futebol/economia , Adolescente , Consumo de Bebidas Alcoólicas , Criança , Feminino , Apoio Financeiro/ética , Promoção da Saúde , Humanos , Masculino , Marketing/estatística & dados numéricos , Fatores Socioeconômicos , Esportes
6.
BMC Public Health ; 20(1): 19, 2020 Jan 07.
Artigo em Inglês | MEDLINE | ID: mdl-31910846

RESUMO

BACKGROUND: Participation in organised sport and physical activity contributes to health-enhancing levels of leisure time physical activity. In Australia, 58% of children aged 0-14 years participated at least once a week in October 2015 - December 2017. To overcome the frequently cited cost barrier, sports voucher incentives have been widely implemented across Australia. METHOD: The financial value of jurisdictional vouchers and the National median financial value were used to calculate the proportion of total annual expenditure on children's participation in sport supported by sports vouchers. Participation rates using AusPlay data were estimated by age, sex and socio-economic index (SEIFA) at state and national level for children aged 0-14 years. RESULTS: Five States and Territories implemented sports vouchers from 2011 to 2018, with a median value of AU$150. Nationally, median annual expenditure for children's sport participation was AU$447 (IQR $194.2-936), with 27% reported expenditure supported by a sports voucher. The proportion of financial support from sports vouchers increased considerably with social disadvantage, rising to over 60% of total expenditure in the most disadvantaged populations. CONCLUSIONS: Socio-economic status was associated with sports-related expenditure and sports participation amongst children. Sport vouchers should target children in the most disadvantaged areas to promote participation in organised sport and physical activity.


Assuntos
Exercício Físico/psicologia , Apoio Financeiro , Promoção da Saúde/economia , Promoção da Saúde/métodos , Motivação , Esportes/economia , Esportes/psicologia , Adolescente , Austrália , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Classe Social
7.
Infect Dis Poverty ; 9(1): 11, 2020 Jan 30.
Artigo em Inglês | MEDLINE | ID: mdl-31996258

RESUMO

Marking the end of the five-year programme initiated by the Chinese Government to lift more than 70 million people out of poverty, the year 2020 is a milestone. Poverty alleviation has moved strongly forward in China and the major health indicators are now better than the average of all middle- and high-income countries. However, the dual burden of infectious and chronic diseases remains a challenge with respect to achieving the health target in the United Nations 2030 Agenda for sustainable development goals (SDGs). In 2015, about 44% of the poor population in China were impoverished by illness but already in 2018, multi-sectoral actions delivered by the Health-related Poverty Alleviation programme had reduced the number almost by half. In the past three years 15 million poor people (98% of the poor population) with infectious and chronic diseases had been treated and taken care of thanks to financial support through multiple health insurance schemes and other governmental subsidies. This article discusses the lessons learnt with regard to health-related poverty alleviation in China with special reference to those still remaining impoverished by illness. Consolidation of the achievements reached and provision of basic needs to those still disadvantaged and in poor health will require a major improvement of accessibility to, and affordability of, health services. The next step towards enhanced productivity and better living conditions will involve upgrading of the capacity of health professionals in the poor regions, promotion of coherent efforts in health-related poverty alleviation and rural revitalization measures. As an additional measure, data monitoring and research on health poverty alleviation should be strengthened as they are essential to generate the evidence and knowledge needed to support the move in the direction envisioned by the SDGs, and the new Healthy China 2030 programme.


Assuntos
Efeitos Psicossociais da Doença , Seguro Saúde/estatística & dados numéricos , Pobreza/estatística & dados numéricos , China , Apoio Financeiro , Humanos , Fatores Socioeconômicos
8.
Acad Med ; 95(1): 44-51, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31599758

RESUMO

Medical school faculty and their colleagues in schools of nursing, public health, social work, and elsewhere often research issues of critical importance to health and science policy. When academics engage with government policymakers to advocate for change based on their research, however, they may find themselves engaged in "lobbying," thereby entering a complex environment of legal requirements and institutional policies that they may not fully understand. To promote academic advocacy, this article explains what is and is not legally permitted when it comes to engaging with policymakers and encourages academic institutions to facilitate permissible advocacy activities.U.S. law permits academic researchers to conduct certain types of policy-focused advocacy without running afoul of legal restrictions on lobbying. Academics acting in their personal capacities and with their own resources may freely engage with policymakers in any branch of government to provide their expertise and advocate for desired outcomes. When acting in their professional capacities, academics are free to engage in most advocacy activities directed to the executive and judicial branches, and they also may advocate to influence legislation and legislators within certain limits that are particularly relevant to academic work. In all cases, academics must take care to not use restricted funds for lobbying.Academic researchers have an important role to play in advancing evidence-based health and science policy. They should familiarize themselves with legal restrictions and opportunities to influence policy based on their research, and their institutions should actively support them in doing so.


Assuntos
Política de Saúde/legislação & jurisprudência , Manobras Políticas , Ciência/legislação & jurisprudência , Academias e Institutos/organização & administração , Pessoal Administrativo/legislação & jurisprudência , Pessoal Administrativo/normas , Defesa do Consumidor/legislação & jurisprudência , Prática Clínica Baseada em Evidências/legislação & jurisprudência , Docentes de Medicina/normas , Apoio Financeiro , Programas Governamentais , Humanos , Saúde Pública/legislação & jurisprudência , Pesquisadores/legislação & jurisprudência , Faculdades de Medicina/normas , Escolas de Enfermagem/normas , Serviço Social , Estados Unidos/epidemiologia
9.
J Sports Sci Med ; 18(4): 758-771, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31827361

RESUMO

This qualitative investigation sought to explore through a socio-cultural lens the perceived early training and competition environment, and support network of world-class Caribbean track and field athletes and the influence on their sport engagement and progression during early childhood and adolescence. Sixteen world-class track and field athletes (8 males and 8 females; M age = 29, SD = 5 years) from 6 English-speaking Caribbean islands took part in semi-structured interviews. A thematic analysis was performed on the transcribed data. Three superordinate themes were identified as key factors that influenced the early sporting development of world-class Caribbean athletes: (1) conducive sporting environment, (2) functional social support network, and (3) key organizational input. Findings revealed that perceived high levels of deliberate play activity in childhood (6 - 12 years) and an intense track and field competition culture in adolescence (13 - 20 years) were conducive to the continued engagement and progression of world-class Caribbean track and field athletes at the junior level. Furthermore, world-class athletes perceived themselves to be positively influenced by the support received from their immediate social support network and key organizations during this period. This study showed that a conducive sporting environment coupled with optimal social and organizational support may have encouraged world-class Caribbean athletes to remain engaged in track and field and to successfully progress within the sport at the junior level. Findings shed light on the sporting culture at the junior level within the Caribbean region and provide insight into key environmental factors that can influence and foster the development of future World Champions and Olympians.


Assuntos
Comportamento Competitivo/fisiologia , Características Culturais , Apoio Social , Atletismo/fisiologia , Atletismo/psicologia , Adolescente , Adulto , Aptidão , Família , Feminino , Apoio Financeiro , Humanos , Masculino , Mentores , Motivação , Grupo Associado , Jogos e Brinquedos , Pesquisa Qualitativa , Atletismo/economia , Índias Ocidentais , Adulto Jovem
10.
Artigo em Inglês | MEDLINE | ID: mdl-31795379

RESUMO

After the launch of governmental financial support for the development of a regional suicide prevention programme, 'Emergency Fund to Enhance Community-Based Suicide Countermeasure' in 2009, suicide mortality rates in Japan have decreased from 25.7 (in 2009) to 16.5 (in 2018) per 100,000 population. Therefore, to explore the effects of governmental financial support on suicide mortality rates in Japan, the present study determined the relationship between the trends of empirical Bayes standardised Mobile Ratio of suicide mortality ratio in all 47 Japanese prefectures (EBSMR-RR) and the execution amounts of 10 sub-divisions of 'Emergency Fund to Enhance Community-Based Suicide Countermeasure' using stepwise multiple regression analysis. The female EBSMR-RR was only significantly/inversely related to the municipal 'development of listeners and leaders', whereas male EBSMR-RR was significantly/inversely related to prefectural 'enlightenment', and 'intervention models', but significantly/directly related to prefectural 'personal consultation support'. The present findings suggest the inverse relationship between financial support and the suicide mortality rates in Japan. Furthermore, the independent factors in the reduction of suicide mortality rates between males and females provide important information for planning a scientifically evidence-based and more cost-effective regional suicide prevention programmes.


Assuntos
Apoio Financeiro , Suicídio/prevenção & controle , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Teorema de Bayes , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Recém-Nascido , Japão/epidemiologia , Masculino , Pessoa de Meia-Idade , Análise de Regressão , Suicídio/economia , Suicídio/estatística & dados numéricos , Adulto Jovem
11.
BMC Med Ethics ; 20(1): 96, 2019 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-31847854

RESUMO

BACKGROUND: Much like academic-industry partnerships, industry financial support of patient advocacy organizations (PAOs) has become very common in recent years. While financial conflicts of interest (FCOI) between PAOs and industry have received more attention in recent years, robust efforts to mitigate these conflicts are still limited. MAIN BODY: The authors outline the possible benefits and ethical concerns that can result from financial interactions between biomedical companies and PAOs. They argue that the use of novel strategies, such as the creation of a standing ethics committee, could be helpful in managing FCOIs and ensuring the warranted trust of PAO's constituents. Although ethics committees to address FCOIs are common in the academic context, its use by PAOs is still limited. The authors conclude by describing the process of development and implementation of such an ethics committee at the Crohn's & Colitis Foundation. CONCLUSIONS: While collaborations with industry can result in conflicts of interest, PAOs can develop strategies to address those conflicts. One such strategy is the creation of a standing independent ethics committee to guide PAOs on new and/or existing programs and protocols as they pertain to their industry relationships.


Assuntos
Conflito de Interesses , Comitês de Ética em Pesquisa , Apoio Financeiro/ética , Fundações , Defesa do Paciente , Ensaios Clínicos como Assunto/economia , Conflito de Interesses/economia , Indústria Farmacêutica , Estudos de Casos Organizacionais
12.
PLoS One ; 14(10): e0224369, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31671133

RESUMO

With the development of economic globalization and information technology, enterprises pay more attention to the sustainable development of their e-commerce. Under this trend, we study the subsidy strategy commonly used by pharmaceutical e-commerce platforms in two-sided market. Based on the two-sided market theory, we set up the two-sided user's utility function and formulate the subsidy strategy as the decision of platform profit optimization. We show that the platform chooses to subsidize consumers only if the net income from consumer is lower than the total revenue of drug retailers and platforms in each transaction; the maximum profit for platform increases with the intensity of the network externality. This study provides theoretical support and decision-making suggestions for the pharmaceutical e-commerce platforms to capture the market share, obtain higher profits and ultimately achieve the sustainable development goal.


Assuntos
Comércio/economia , Competição Econômica/economia , Farmacoeconomia/tendências , Tomada de Decisões , Apoio Financeiro , Humanos , Renda
13.
Geriatr Gerontol Int ; 19(12): 1268-1274, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31758643

RESUMO

AIM: A rotating savings and credit association - an informal local microfinance group - provides community-dwelling older adults with cohesive social capital. This study examined whether participation in mujin, a traditional Japanese rotating savings and credit association, affected the maintenance of higher-level functional capacity in older adults. METHODS: We studied 10 991 older adults living in 24 municipalities in Japan who were aged ≥65 years, and physically and cognitively independent. We carried out a baseline survey in 2013 and a follow-up survey in 2016. Higher-level functional capacity, consisting of instrumental activities of daily living, intellectual activity and social role, was assessed using the Tokyo Metropolitan Institute of Gerontology Index of Competence. To address potential reverse causation, we used stabilized inverse probability weights to balance characteristics at baseline between mujin participants and non-participants. RESULTS: In our analytic sample, 406 out of 10 991 older adults (3.7%) participated in mujin at the baseline. Our weighted logistic regression showed that mujin participants were more likely to maintain higher-level functional capacity (i.e. full marks in the Tokyo Metropolitan Institute of Gerontology Index of Competence) 3 years later compared with non-participants (odds ratio 1.75, 95% confidence interval 1.29-2.39). Furthermore, independent social role functioning and intellectual activity were associated with participation in mujin for an equal number of both sexes, as well as people of high social standing. CONCLUSIONS: The present study suggests that rotating savings and credit associations can help older adults maintain their independence in a higher-level functional capacity. Furthermore, the members' diversity might add to these beneficial effects. Geriatr Gerontol Int 2019; 19: 1268-1274.


Assuntos
Atividades Cotidianas , Redes Comunitárias/estatística & dados numéricos , Renda/estatística & dados numéricos , Capital Social , Idoso , Feminino , Apoio Financeiro , Avaliação Geriátrica , Humanos , Vida Independente , Japão , Masculino , Estudos Prospectivos , Inquéritos e Questionários
14.
PLoS One ; 14(10): e0223175, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31589643

RESUMO

There is few significant attempt to integrate environmental regulation, government financial support, and corporate technological innovation in a methodological framework. Employing the data of the industrial enterprises with an annual turnover of over 20 million yuan from 30 Chinese provinces or municipalities between 2008 and 2016, this paper applies the fixed effect regression model to reveal the relationships between environmental regulation, government financial support, and corporate technological innovation simultaneously. Results show that: (1) there exists a U-shaped relation between environmental regulation intensity and technological innovation of enterprises which declines first and then climbs up, and China is still at the stage of inhibition before the "inflection point". (2) government financial support does not significantly work on technological innovation directly, but environmental regulation drives this effect to be achieved; when the value of lnER is higher than 3.69, government financial support can significantly facilitate corporate technological innovation. (3) the comparison between regional samples reveals that heterogeneity exists in the influence of environmental regulation intensity and government financial support on corporate technological innovation. The threshold value of enabling effects of environmental regulation in eastern region is higher than that of the central and western region. These results remain consistent after we experiment several robustness checks. Theory and policy implications of our work are discussed.


Assuntos
Meio Ambiente , Invenções , Controle Social Formal , China , Poluição Ambiental/economia , Poluição Ambiental/prevenção & controle , Apoio Financeiro , Governo , Invenções/economia , Investimentos em Saúde , Modelos Econométricos , Patentes como Assunto , Análise de Regressão , Pesquisa/economia
16.
Glob Health Action ; 12(1): 1659098, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31496422

RESUMO

Background: HIV/AIDS prevention has historically encountered many obstacles. Understanding the factors affecting HIV/AIDS prevention is central to designing and implementing suitable context-specific interventions. Research relating to HIV prevention in the Middle East and North African region is required to address the gradually increasing HIV epidemic. Objective: This study aimed to explore the perspectives of employees/health care professionals who are working or have worked within HIV prevention in Sudan and Yemen on the challenges and facilitating factors facing HIV prevention. Methods: A qualitative approach was employed using an open-ended questionnaire. Sixteen stakeholders from governmental and non-governmental agencies participated in the study. The questionnaire focused on the various challenges and facilitating factors facing HIV prevention as well as proposed possible solutions from the perspectives of the participants. The data were analysed using thematic analysis. Results: The study illustrated the similarities in context and HIV prevention systems between Sudan and Yemen. Thematic analysis resulted in three main themes: I) much is achieved despite difficulties; II) a programme left to be paralysed; this theme addressed the main obstacles facing HIV prevention in Sudan and Yemen generating a total of six sub-themes; III) comprehensive change is needed. The participants drew focus and attention to vital changes required to improve the delivery of HIV prevention services. Conclusion: Increased financial support for HIV prevention in Sudan and Yemen is urgently needed. De-stigmatisation and increased political support, advocacy and improved legislation for people living with HIV (PLHIV) are required for the sustainability and effectiveness of HIV prevention programmes in Sudan and Yemen. Civil society organisations must be aided and supported in their role in engaging key populations.


Assuntos
Eficiência Organizacional , Infecções por HIV/prevenção & controle , Promoção da Saúde/organização & administração , Feminino , Apoio Financeiro , Pessoal de Saúde , Humanos , Entrevistas como Assunto , Masculino , Vigilância da População , Pesquisa Qualitativa , Sudão , Inquéritos e Questionários , Iêmen
17.
Cancer Radiother ; 23(6-7): 617-624, 2019 Oct.
Artigo em Francês | MEDLINE | ID: mdl-31477441

RESUMO

Among over 100 proton therapy centres worldwide in operation or under construction, French proton therapy is coming to full maturity with the recent opening of the Nice (1991, upgrade in 2016) and Caen (2018) facilities next to the Orsay (1991, upgrade in 2010) centre. Proton therapy is a national priority for children and young adults in all three centres. The patient-related activity of the three French centres is coordinated via the Protonshare portal to optimise referral by type of indication and available expertise in coordination with the French society of radiation oncology SFRO and French radiotherapy centres. The centres are recognised by the French Health Care excellence initiative, promoted by the ministry of Foreign Affairs. The three centres collaborate structurally in terms of clinical research and are engaged at the international level in the participation to European databases and research initiatives. Concerted actions are now also promoted in preclinical research via the Radiotransnet network. Ongoing French developments in proton therapy are well presented in international hadron therapy meetings, including European Proton Therapy Network and Particle Therapy Cooperative Oncology Group. Proton therapy teaching in France is offered at several levels and is open to colleagues from all radiation oncology centres, so that they are fully informed, involved and trained to facility recognition of possible indications and thereby to contribute to appropriate patient referral. This close collaboration between all actors in French radiation oncology facilitates the work to demonstrate the required level of medical and scientific evidence for current and emerging indications for particle therapy. Based on that, the future might entail a possible creation of more proton therapy facilities in France.


Assuntos
Institutos de Câncer , Neoplasias/radioterapia , Terapia com Prótons , Radioterapia (Especialidade) , Adolescente , Adulto , Pesquisa Biomédica/organização & administração , Institutos de Câncer/organização & administração , Institutos de Câncer/provisão & distribução , Criança , Ciclotrons/provisão & distribução , Apoio Financeiro , França , Humanos , Cooperação Internacional , Terapia com Prótons/economia , Terapia com Prótons/instrumentação , Terapia com Prótons/métodos , Radioterapia (Especialidade)/educação , Radioterapia (Especialidade)/organização & administração , Adulto Jovem
18.
Transplant Proc ; 51(8): 2508-2513, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31473008

RESUMO

BACKGROUND: Financial incentives for deceased organ donation are associated with many controversial ethical issues. This study examines the perspectives of medical students and staff members on financial incentives for the families of brain-dead organ donors. METHODOLOGY: A structured survey form was used between December 7, 2017 and January 28, 2018 to elicit opinions on financial incentives for the families of brain-dead organ donors. Forty-three medical staff members and 81 medical students participated in the survey voluntarily. The opinions on the financial incentive system and the relationship between willingness to give information about organ donation to families and a financial incentive system were assessed. RESULTS: The majority of the participants (81.4%) had positive thoughts on organ donation. More than half of the participants (60.5%) thought that the financial incentive system did not erode the ethical purity of organ donation. As charge doctors, most respondents (84.6%) were willing to give information about organ donation to family members in the presence of financial incentives. However, the percentage decreased significantly to 60.5% when financial incentive was no longer factored into consideration (P < .001). LIMITATION: The study population is small, and the participants are not representative of the general population. CONCLUSION: The opinions of medical students and medical staff on financial incentives for deceased organ donation were generally positive. Financial incentives proved to be a potential influencing factor as an option of organ donation to be given to families.


Assuntos
Apoio Financeiro , Corpo Clínico/psicologia , Transplante de Órgãos/psicologia , Estudantes de Medicina/psicologia , Obtenção de Tecidos e Órgãos/economia , Adulto , Atitude , Atitude do Pessoal de Saúde , Morte Encefálica , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Motivação , Transplante de Órgãos/economia , República da Coreia , Inquéritos e Questionários , Doadores de Tecidos/psicologia
20.
Int J Health Policy Manag ; 8(7): 403-411, 2019 07 01.
Artigo em Inglês | MEDLINE | ID: mdl-31441277

RESUMO

BACKGROUND: Disinvestment from inefficient health services may be a potential solution to rising healthcare costs, but there has been poor uptake of disinvestment recommendations. This Australian study aims to understand how health professionals react when confronted with a plan to disinvest from a health service they previously provided to their patients. METHODS: This qualitative study took place prior to the disinvestment phase of a trial which removed weekend allied health services from acute hospital wards, to evaluate the effectiveness and cost effectiveness of the service. Observations and focus groups were used to collect data from 156 participants which was analysed thematically. RESULTS: Initial reactions to the disinvestment were almost universally negative, with staff extremely concerned about the impact on the safety and quality of patient care and planning ways to circumvent the trial. Removal of existing services was perceived as a loss and created a direct threat to some clinicians' professional identity. With time, discussion, and understanding of the project's context, some staff moved towards acceptance and perceived the trial as an opportunity, particularly given the service was to be reinstated after the disinvestment. CONCLUSION: Clinicians and health service managers are protective of the services they deliver and can create barriers to disinvestment. Even when services are removed to ascertain their value, health professionals may continue to provide services to their patients. Measuring the impact of the disinvestment may assist staff to accept the removal of a service.


Assuntos
Atitude do Pessoal de Saúde , Apoio Financeiro , Serviços de Saúde/economia , Austrália , Grupos Focais , Entrevistas como Assunto , Observação , Pesquisa Qualitativa
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